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    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>H+ 后台主题UI框架 - 空白页</title>
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    <meta name="description" content="">

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</head>

<body style="color:#333;padding:3px;">
    <!-- 标题 -->
    <div class="page-heade">
        <h2 class="title_color text-center">市场费用补发票申请</h2>
    </div>
    <!-- 标题 -->
    <div class="contact-box" style="margin-bottom: 0;border-bottom: 0">
        <p>请输入供应商名称或输入供应商编号后在联想下拉框中选择供应商，然后点击确认提交按钮。</p>
    </div>
    <form action="" method="get" class="form-inline">
    <div class="contact-box">
        <div class="form-group">
               <label for="" class="form-label">供应商编号：</label><input type="text" class="form-control" placeholder="请输入关键字或空格查询" style="min-width: 180px;width: 180px" name="ProNum">
            </div>
              <div class="form-group">
               <label for="" class="form-label">供应商名称：</label><input type="text" class="form-control" placeholder="请输入关键字或空格查询" style="min-width: 240px;width: 240px" name="ProName">
            </div>
             <div class="form-group">
               <label for="" class="form-label">原申请文件编号：</label><input type="text" class="form-control" name="oldNum">
            </div>
    </div>
     <table class="table row-margin-top table-bordered text-center bud_hei">
          <tr>
           <td colspan="2" class="text-left"><span class="colorRed">温馨提示：请在发票粘贴联上注明此申请单编号：201711170002</span><a href="javascript:;">点击查看图例</a></td>
          </tr>
          <tr>
            <td style="min-width: 100px;width: 100px;height: 120px">备注：</td>
            <td style="width:80%;height: 120px" class="text-left">
                <textarea name="beizhu" id="" style="height: 100%;width: 60%;user-select:none;overflow-y: auto"></textarea><span>(500)</span>
            </td>
          </tr>
      </table>
           <div class="form-group white-bg" style="margin:20px 10px 20px 20px">
        <input type="file" id="exampleInputFile1">
        <p class="help-block" style="color:#1295d2">注：最多上传15个文件，每个文件小于50M,支持格式：</p>
        <p class="help-block" style="color:#1295d2">jpg,bnp,gif,png,jpeg,tif,raw,doc,docx,xls,xlsx,ppt,pptx,txt,pdf,rar,zip,mp4,avi,rmvb,rm,mid,3gp,AVI,3GP,,mpg,mp3,wma,wav</p>
      </div>
      <div class="text-center">
            <button class="btn btn-warning">保存为草稿</button>
            <button class="btn btn-success" style="margin-left: 20px">保存并提交流程</button>
      </div>
   </form>
    <div class="footer fixed_full text-center" id="fixBG">
        本次补发票未税金额合计：<strong class="colorRed">0.00元</strong>;税金合计：<strong class="colorRed">0.00元</strong>;含税金额合计：<strong class="colorRed">0.00元</strong>;实际金额合计：<strong class="colorRed">0.00元</strong>;
    </div>
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</body>

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